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<html class="no-js" lang="en"> <!--<![endif]--> 
<head> 
  <meta charset="utf-8"> 
 
  <title>Login Form</title> 
  
  <link rel="shortcut icon" href="/favicon.ico"> 
 
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</head> 
 
<body> 
 
  <div id="container"> 
    <header> 
 
    
    </header> 
 
    	<div id="main" role="main"> 
 
 
                <form method="post" action="#" id="authForm"> 
 
                    <fieldset> 
 
                        <label for="description">Description</label> 
 
		               		  <input type="text" name="description" id="description" required autofocus> 
 
                       <label for="value">Value</label> 
 
	        	            <input type="text" name="value" id="value" pattern="^\d{1,8}(\.\d{0,2})?$" title="Value dot separated" required> 
	        	            
                           <label for="city">Category:</label>
	                         <input id="city" />
                          
                           <label for="log" style="display:none" id="label_for_log"> Selected Categories: </label>
                            <div id="log"></div>
                        
                        
                       
                        <div class="tzSelect">
                          <div class="selectBox"> </div>
	                        <select name="departments" id="account" class = "selectBox">
		                        <option>Select Account</option>
	                        </select>
		                    </div>
	
	                      


            		</fieldset> 
 
                    <fieldset> 
                      <p></p>
                    	<div id="button" class="button">GO</div>
 
                    </fieldset> 
 
 
           		</form> 
 
 
 
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